Student Nurse with a brag!

I'm feeling pretty great! This past spring just before completing my LPN training my last clinical was in LTC. I rekindled a friendship with a resident that I had met earlier in the year during our very first clinicals. She remembered me as I had cared for her roomate. She had declined somewhat and now required more attention so I was assigned to her several times over our 6 week rotation. We got very close very quickly and I really enjoyed our friendship. She has severe osteoporosis and has had a laminectomy and has compression fractures. This woman's face is practically in her lap she is so hunched over. She never complained and was always pleasant. She really made an effort not to be any trouble to anyone. I assisted her with whirlpool baths a few times and noticed a great improvement in her mobility and mood following the baths. One day she began kicking her legs gently up and down and splashing the water with her hands almost like a child. I commented that she seemed to really enjoy her whirlpools. She said, "Oh yes, they help me so much. I feel like a different person after them. I wish I could have them more often." She only got the whirlpools once or twice a week. I asked her if she'd ever told anyone this and she said, "No, there wouldn't be time. I don't want to make more work for anyone." So, since the entire reason I'm in nursing to begin with is because I want to be a Pt advocate, I had to DO SOMETHING! First, I went to the RN who I had a good relationship with, and asked her if it would be possible for the whirlpools to take place more often. The response was immediate. "No, we don't have time. There just isn't enough help to go around. Everyone only gets two baths a week, so we can't make an exception for her." I tried not to let my disappointment show because the instant response (you know, where you can tell she could not care less about what you are saying and is not even going to consider it for half a second) completely caught me off guard. I asked if it could not be arranged for her since it really is not a bath for hygiene purposes, but pain relief. I stated that I thought surely if this was effective at relieving her pain that it could be considered as a therapeutic bath and should be given more often. After all, how could we deny somone the chance to have chronic pain relieved. (Somone who wears a duragesic patch and has narcotic pain meds ordered PRN.) She continued to dig in her heels, so I relented. Then, I mulled it over and talked to my instructor. She asked what I thought I should do. I told her that I felt that if I was going to take no for an answer that quickly then I wasn't going to make much of a Pt advocate. She smiled and told me to work on it if I wished to. The next day I approached a woman in rehab who helped my Pt with her therapy and asked her if she had any suggestions for how to accomplish this simple request. She suggested that I speak to her case worker. So, I did. I approached her in her office and tried to be as diplomatic as I could. I told her that I didn't want to step on anyone's toes and that I certainly didn't think I was an expert as a first year student, but that I really believed that more frequent whirlpools would benefit this Pt. I added that the Pt had mentioned her desire for this to me, but didn't want to bother the staff. I got a very enthusiastic response. The woman thought it was a great idea and was sorry that my previous attempt to make this happen met with resistance. She then said she would work on it and get back with me. To make a very long story short, she had the plan in place by the end of the day. She said that the whirlpools had been added to her plan of care as "therapeutic whirlpools" 5 days per week. Rehab aids would give the baths so the nurses would not have a time constraint issue, and her medicare would pay the fees. I was elated, but still a little skeptical as to wether or not this would REALLY happen. The case manager was very genuine and even thanked me for the wonderful work I had done at finding out what the Pt needs were and following through with making something happen. She said she was impressed and embarrassed that no one else had thought of it. ANYWAY, I stopped in the other day to see how things were going and..... 2 months after the fact, the whirlpools ARE happening 5 days a week and my Pt is tickled and very grateful. It feels so good to have made a difference for someone. I don't care how small it is!!!!! Now, I can't wait to get my hands on some more patients!!!